Respiratory function and functional capacity in chronic stroke patients 1

Abstract

Introduction: Cerebrovascular accident (CVA) or stroke results in weakness of the trunk muscles and physical unfitness. Objectives: To evaluate respiratory changes caused by stroke and correlate them with the functional capacity of chronic stroke patients who were treated at the Clinical Center of Physical Therapy of the Pontifical Catholic University of Minas Gerais, Betim. Methods: Fifteen patients were recruited for assessment of respiratory function and functional capacity. We measured maximum inspiratory pressure (MIP), maximal expiratory pressure (MEP), peak expiratory flow (PEF), vital capacity (VC), and functional capacity using the six-minute walk test (6MWT). Test results were compared with reference values using an (1):95-102Machado ACM, Silva NGM, Diniz GCL, Pessoa BP, Scalzo PL 96 unpaired Student's t-test or the Mann-Whitney test. Respiratory variables were correlated with the distance walked in the 6MWT using Spearman's correlation test. Results: The sample had a mean age of 58.2 ± 13.4 years, and most patients had a diagnosis of ischemic stroke and left hemiparesis. The following values were obtained: MIP (47.7 ± 22.2 cmH2O); MEP (47.5 ± 20.3 cmH2O); PEF (351.3 ± 90.8 L/min); VC (3.0 ± 0.91 L); and 6MWT (222.4 ± 101.6 m). The MIP, MEP, PEF, and 6MWT values measured in this study were statistically significantly lower (p < 0.001) than the reference values. There was no statistically significant correlation between the distance walked in the 6 MWT and respiratory variables (p > 0.005). Conclusion: Our results suggest that, despite the decrease in respiratory muscle strength, PEF, and VC, these variables did not correlate with the functional capacity of the chronic stroke patients assessed in this study. Introdução: O acidente vascular encefálico (AVE) resulta em fraqueza dos músculos do tronco e descondicionamento físico. Objetivos: Avaliar as alterações respiratórias e correlacioná-las com a capacidade funcional de pacientes pós AVE crônicos do Centro Clínico de Fisioterapia da PUC Minas Betim. Métodos: Foram recrutados 15 pacientes para avaliação respiratória e da capacidade funcional. Foram avaliadas a pressão inspiratória máxima (PImáx), pressão expiratória máxima (PEmáx), pico de fluxo expiratório (PFE), capacidade vital (CV) e a capacidade funcional a partir do teste de caminhada de seis minutos (TC6M). Os resultados foram comparados com os valores de referência utilizando os testes t de Student não pareado ou teste Mann-Whitney. As variáveis respiratórias foram correlacionadas com a distância percorrida no TC6M por meio do Coeficiente de Correlação de Spearman.Resultados: A amostra apresentou idade média de 58,2 ± 13,4 anos, sendo que o diagnóstico da maioria foi AVE isquêmico e hemiparesia à esquerda. Os valores obtidos foram PImáx (47,722,2 cmH 2 O); PEmáx (47,5 20,3 cmH 2 O); PFE (351,390,8 L/min); CV (3,00,91 L) e TC6m (222,4101,6 m). Quando comparados com os valores de referência, os valores de PImáx, PEmáx, PFE e TC6M foram estatisticamente menores (p < 0,001). Não houve correlação es...

The relationship of respiratory functions and respiratory muscle strength with trunk control, functional capacity, and functional independence in post‐stroke hemiplegic patients

“…Stroke affects the integrity of the nervous system, reduces the coordination of respiration, and decreases the capacity of diaphragm, which has high oxidative capacity and capillaries and is resistant to fatigue after activity (Machado et al., 2016). In addition, trunk muscle weakness and spasticity associated with deficiencies in neural movement control reduce trunk stability, hinder the execution of the activity, and make the energy required costly.…”

“…In a study, it was reported that there is a statistically significant relationship between the functional capacity and trunk control level of patients with stroke, and it has been reported that these variables also affect respiratory function parameters (Ipek, 2019). In another study, it was shown that pulmonary function parameters and respiratory muscle strength in stroke patients were not related to functional capacity (Pessoa & Scalzo, 2016). In a systematic review with meta‐analysis, it was reported that respiratory muscle training provided a significant increase in walking ability depending on functional capacity in hemiplegic patients, and it was concluded that respiratory function parameters and respiratory muscle strength were significantly related to functional capacity (Pozuelo‐Carrascosa et al., 2020).…”

Avaliação do pico de fluxo expiratório em indivíduos pós acidente vascular cerebral - AVC

“…Interfere, dessa forma, nas funções cardiorrespiratórias, diminuindo-as, e gerando padrões respiratórios anômalos 5,6 .…”

“…Desse modo, doenças associadas ao sistema respiratório e neurológico, como o AVC, podem causar alterações na função pulmonar 5 . Com isso, os prejuízos de origem neurológica no sistema respiratório têm repercussão na diminuição das capacidades e volumes pulmonares.…”

Biomedical system to evaluate pulmonary function in patients with post-stroke hemiparesis

“…Stroke, a neurological disorder that has major social impacts [1], results from changes in blood irrigation, and can be ischemic, via occlusion of a cerebral artery, or hemorrhagic, due to vascular rupture (aneurism and arteriovenous malformations), the latter being the most severe and the former the most frequent [2,3]. It is the second leading cause of death and the leading cause of physical and mental disability worldwide, resulting in dependence in the activities of daily living (ADL) due to trunk muscle weakness and physical deconditioning [4,5].…”